Ignored or underestimated - evaluation and treatment of cardiovascular risk factors in patients with adrenal insufficiency.

IF 3.7 3区医学 Q2 Medicine

Endocrine Pub Date : 2025-02-25 DOI:10.1007/s12020-025-04192-0

Anja Wasmuth, Iris van de Loo, Julia Domberg, Birgit Harbeck

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引用次数: 0

Abstract

Purpose: Patients with adrenal insufficiency (AI) are known to have a higher cardiovascular risk (CVR) than the normal population. In particular arteriosclerosis, coronary heart disease, arterial hypertension, hyperlipoproteinemia as well as metabolic disturbances contribute to the increased morbidity and mortality. Aim of this study was to evaluate known CVR factors along with the quality of care by the treating physicians.

Methods: To this end the medical records of AI patients were screened for CVR factors and the treatment initiated was documented. In addition, a questionnaire evaluating CVR factors was analyzed if available.

Results: In total, 327 AI patients were included in the study. At least 298 of these patients were found to have one or more CVR factors. Ninety-one patients were diagnosed with arterial hypertension, of these 40 patients (44%) still showed increased blood pressure (BP) values. Of all AI patients, about 25% (n = 83) did not have measurements to calculate their BMI, even though obesity is known as a major risk factor for cardiovascular events. Out of 46 patients with diabetes, one-quarter still had increased HbA1c values. Regarding hyperlipoproteinemia, only 2% of AI patients achieved normal lipid values across all parameters (n = 8). Interestingly, at least one lipid variable was untested in 150 patients (46%).

Conclusion: Our study demonstrates (1) the high rate of CVR factors in AI patients, leading to increased morbidity and eventually mortality, (2) AI patients are inadequately monitored and treated for CVR factors, (3) treating physicians should be aware of this risk to minimize complications where possible.

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忽视或低估——肾上腺功能不全患者心血管危险因素的评估与治疗。

目的：已知肾上腺功能不全（AI）患者比正常人群具有更高的心血管风险（CVR）。特别是动脉硬化、冠心病、动脉高血压、高脂蛋白血症以及代谢紊乱导致发病率和死亡率增加。本研究的目的是评估已知的CVR因素以及治疗医生的护理质量。方法：对AI患者的病历进行CVR因素筛选，并记录开始治疗的情况。此外，如果有问卷评估CVR因素，则进行分析。结果：共纳入327例AI患者。这些患者中至少有298人被发现有一个或多个CVR因素。91例患者被诊断为动脉性高血压，其中40例（44%）仍有血压升高。在所有AI患者中，大约25% （n = 83）没有测量来计算他们的BMI，尽管肥胖被认为是心血管事件的主要危险因素。在46名糖尿病患者中，四分之一的患者HbA1c值仍然升高。关于高脂蛋白血症，只有2%的AI患者在所有参数中达到正常的脂质值（n = 8）。有趣的是，在150名患者（46%）中，至少有一种脂质变量未被检测。结论：我们的研究表明(1)人工智能患者中CVR因素的发生率高，导致发病率和最终死亡率增加；(2)人工智能患者的CVR因素监测和治疗不足；(3)治疗医生应意识到这一风险，尽可能减少并发症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.